A draft SHOP enrollment form (CMS image)

Mississippi insurance regulators seem to want it both ways. They’re asking the Obama administration for permission to run a small-group health insurance exchange. Just not the individual one.

But Sarah Lueck and other health policy specialists at the Center on Budget and Policy Priorities, a non-partisan think tank often described as liberal, say a state shoudln’t be allowed to split the exchange work with the feds.

Mike Chaney, the Mississippi insurance commissioner, and the CBPP health policy specialists talk about the idea of splitting the Small Business Health Options Program exchange and individual exchange jobs in comments sent to the Centers for Medicare & Medicaid Services.

CMS has already given Utah and New Mexico permission to set up SHOP exchanges while letting the feds run the states’ individual markets.

How CMS addresses the issue in other states could determine whether brokers and managers in those states deal with local exchange managers or Washington ones.

Earlier this year, HHS rejected a Mississippi exchange program blueprint that called for the state to run both an individual and a SHOP exchange. A majority of Mississippi’s state legislators oppose the idea of the state setting up an exchange, and HHS officials said that could cause problems.

According to the draft regulations, a state can get permission to split the exchange job with the feds only if CMS has approved the state’s exchange blueprint.

Chaney requests the feds let the state run its SHOP exchange next year even if the state’s blueprint filing already has been rejected.

At the CBPP, Lueck and her colleagues say letting a state split the exchange job with CMS could make running an exchange program too complicated and too expensive.

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